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CT Scan

Kishwaukee Hospital, DeKalb


CPT Code

Test/Procedure

Cost

74177 Abdomen & Pelvis w/Contrast $5,136
74176 Abdomen & Pelvis w/o Contrast $4,107
74178 Abdomen & Pelvis w/wo Contrast $6,234
74174 Angio Abdomen & Pelvis w/wo  $3,362
71275 Angiography Chest $2,829
72125 Cervical Spine w/o Contrast $2,829
71260 Chest w/Contrast $2,819
71250 Chest w/o Contrast $2,455
70486  Facial w/o Contrast $2,257
70450 Head w/o Contrast $2,071
70470 Head w/wo Contrast $2,951
73700  Lower Extremity w/o Contrast $2,069
72131  Lumbar Spine w/o Contrast $2,264
70486 Sinuses w/o Contrast $2,257
70491  Soft Tissue Neck w/Contrast $2,286
73200  Upper Extremity w/o Contrast $2,073


Valley West Hospital, Sandwich


CPT Code

Test/Procedure

Cost

74160 Abdomen w/Contrast $2,702
74178 Abdomen & Pelvis w/o Contrast $6,122
74177 Abdomen & Pelvis w/Contrast $4,773
71275 Angiography Chest $2,115
72125 Cervical Spine w/o Contrast $3,779
71260 Chest w/Contrast $2,432
71250  Chest w/o Contrast $1,824
70486 Facial w/o Contrast $2,322
70450 Head w/o Contrast $2,343
73700 Lower Extremity w/o Contrast $1,377
72131  Lumbar Spine w/o Contrast $3,601
72192 Pelvis w/o Contrast $2,343
70491 Soft Tissue Neck w/Contrast $1,915
72128 Thoracic Spine w/o Contrast $2,161


These represent KishHealth System charges only and do not include physician's fees such as your surgeon, pathologist, anesthesiologist or radiologist. Please contact those offices directly for charge information. These prices are current as of May 1, 2015 and are subject to change. For the most up to date charges, please contact the KishHealth System Business Office at 800.397.1521 ext. 153386.

Contact Us

Kishwaukee Hospital in DeKalb and Valley West Hospital in Sandwich offer a variety of options for payment of your patient balance.

855.286.2861
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